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Difference Between HIV and AIDS

by | Jan 1, 2023 | Info | 0 comments

HIV and AIDS Overview

The difference between human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is that HIV is a virus that weakens the immune system. AIDS is a condition that can happen as a result of an HIV infection when the immune system is severely weakened.

A person cannot get AIDS if they are not infected with HIV. Treatment is available to slow down the effects of the virus, not every patient with HIV progresses to AIDS. But without treatment, almost all patients living with HIV will progress to AIDS.

HIV is a virus that targets and alters the immune system, increasing the risk and impact of other infections and diseases. Without treatment, the infection might progress to an advanced stage called stage 3 HIV, or AIDS.

Due to medical advances, patients with HIV who have access to quality healthcare and receive appropriate treatment rarely develop AIDS, or stage 3 HIV.

The World Health Organization (WHO) and some other health agencies observe that many people with HIV manage the condition and live long healthy lives.

Life expectancy of a person with HIV is now approaching that of someone who tests negative for the virus. However, this only applies if the person takes a combination of drugs called antiretroviral therapy regularly and exactly how their doctor prescribes it.

As of 2020, around 73% of adults and 54% of children with HIV worldwide were receiving lifelong antiretroviral treatment.


What is HIV?

Human immunodeficiency (HIV) virus, attacks immune cells called CD4 cells. These are types of T cells, white blood cells that circulate around the body, detecting infections and faults and anomalies in other cells.

HIV targets and infiltrates CD4 cells, using them to create more copies of the virus. In doing so, it destroys the cells and reduces the body’s ability to combat other infections and diseases. This increases the risk and impact of opportunistic infections and some types of cancer.

HIV infects and destroys cells of your immune system, making it hard to fight off other diseases. When HIV has severely weakened your immune system, it can lead to acquired immunodeficiency syndrome (AIDS).

Because HIV works backward to insert its instructions into your DNA, it is called a retrovirus.

However, it is worth noting that some people have HIV for long periods without experiencing any symptoms.

HIV is a lifelong condition, but treatments and certain strategies can prevent the virus from transmitting and the disease from progressing.


What is AIDS?

Acquired immunodeficiency syndrome (AIDS) is the final and most serious stage of an HIV infection. Patients with AIDS have very low counts of certain white blood cells and severely damaged immune systems. They may have additional illnesses that indicate that they have progressed to AIDS.

Without treatment, HIV infections progress to AIDS in about 10 years.

Doctors identify AIDS as having a CD4 count of fewer than 200 cells per cubic millimeter. They may also diagnose AIDS if a patient has characteristic opportunistic infections, associated types of cancer, or both.

When a patient with HIV does not receive treatment, the immune system gradually wears down, likely leading to stage 3 HIV. However, advances in antiretroviral treatments have made this progression increasingly less common.

In 2020, approximately over 1.1 million patients were living with HIV in the United States, and 18,489 people with HIV died. These deaths were due to any cause.


Causes of HIV

HIV is caused by the human immunodeficiency virus. The virus attacks the helper T-cells of your immune system, leaving it weakened.

AIDS is caused by having too few immune cells to fight off other illnesses.

Human immunodeficiency (HIV) can transmit when body fluids containing the virus come into contact with a permeable barrier in the body or small breaks in moist tissues of areas, such as the genitals.

Specifically, HIV can transmit via following body fluids:

  • Blood
  • Breast milk
  • Pre-seminal fluid
  • Rectal fluids
  • Semen
  • Vaginal fluids

The virus cannot transmit through saliva, so a person cannot contract HIV through open-mouthed kissing, for example.

One of the main causes of HIV transmission in the United States is anal or vaginal intercourse. Transmission of HIV occurs when individuals do not use barrier protection, such as a condom, during intercourse or are not taking pre-exposure prophylaxis (PrEP), a treatment that aims to prevent HIV transmission among people with known risk factors.

Sharing equipment for injecting drugs is another main cause of HIV transmission in the United Staes.

Less commonly, HIV transmits to babies during pregnancy, childbirth, or breastfeeding or chest feeding.

There is also a chance of transmission through blood transfusions, though the risk is extremely low when blood donations undergo effective screening.

Undetectable Levels of HIV are Un-transmittable

HIV can only transmit through fluids that contain a certain amount of the virus. If a person has undetectable levels of HIV, the virus cannot transmit to another person. While there’s effectively no risk of transmission during sex, risk reduction is still unknown for sharing injection drug equipment.

Additionally, the risk of transmission is very much reduced, but not negligible, for transmission during pregnancy and childbirth. Doctors use a shorthand to refer to the fact that undetectable levels of HIV are un-transmittable: U=U.

Doctors consider HIV to be undetectable when the amount of the virus in the body is so low that a blood test cannot identify it.

Achieving undetectable levels requires a patient to continually receive effective treatment and carefully follow the recommended treatment plan. This usually involves taking medications every day.

A patient with undetectable levels still has HIV, and regular monitoring with blood tests is key to maintaining this status.


HIV Progression to AIDS

Access to better antiviral treatments has dramatically decreased deaths from AIDS globally, even in resource-poor countries. Thanks to these life-saving treatments, most people with HIV in the U.S. today don’t develop AIDS. Untreated, HIV typically turns into AIDS in about 8 to 10 years.

When AIDS develops, the immune system has been severely damaged. You’ll be more likely to develop diseases that wouldn’t usually cause illness in a patient with a healthy immune system. These are called opportunistic infections or opportunistic cancers.

The chances of HIV progressing to AIDS vary widely from patient to patient and depend on many factors, including:

  • Accessibility of quality healthcare
  • A person’s genetic resistance to certain strains of HIV
  • Body’s ability to defend against HIV
  • Patient’s age 
  • Presence of other infections
  • Strain of HIV, as some are drug-resistant


Signs and Symptoms

HIV infection develops in three stages. Without treatment, it gets worse over time and eventually overpowers the immune system. The symptoms depend on the stages of the virus.

For the most part, other infections with bacteria, other viruses, fungi, or parasites cause the more pronounced symptoms of HIV.

Early or First Stage Symptoms of HIV

Most patients are not aware when they’ve been infected with HIV. But they may have symptoms within 2 to 6 weeks after getting the virus. This is when your body’s immune system puts up a fight. It’s called acute retroviral syndrome or primary HIV infection.

Some patients with HIV have no symptoms for months or even years after contracting the virus. Partly because of this, about 13% of people with HIV in the U.S. do not know that they have it.

While a person with no symptoms may be unlikely to seek care, there is still a high risk of transmission. For this reason, experts recommend regular testing so that everyone is aware of their HIV status.

Around two-thirds of patients with HIV develop flu-like symptoms around 2–4 weeks after contracting the virus. These symptoms are collectively called acute retroviral syndrome.

The symptoms of HIV are similar to those of other viral illnesses, and they’re often compared to the flu. They typically last a week or two and then go away.

Early signs of HIV include the following:

These symptoms result from the immune system fighting off the infection. Individuals who have several of these symptoms and may have contracted HIV in the past 2–6 weeks should take a test.

Asymptomatic HIV

After the symptoms of acute retroviral syndrome resolve, many people may not experience any HIV symptoms for years.

While they feel well and appear healthy, the virus develops and damages the immune system and organs. If the person does not take medication that prevents the replication of the virus, this slow process can continue for 10 years or longer. However, some patients may progress faster.

Taking antiretrovirals can stop this process and suppress the virus completely.

Late-Stage HIV Infection

If a patient with HIV does not receive effective treatment, the virus weakens the body’s ability to fight infection, exposing it to serious illnesses.

When CD4 cells are severely depleted, at fewer than 200 cells per cubic millimeter, a doctor can diagnose stage 3 HIV.

Certain opportunistic infections involving bacteria, viruses, fungi, or mycobacteria also help a doctor identify stage 3 HIV.

Symptoms of Stage 3 HIV can include:

A patient with HIV stage 3 has a significantly increased risk of developing a life-threatening illness. Without treatment, patients with AIDS typically live for around 3 years after diagnosis.

However, by taking other medications alongside HIV treatment, a patient with AIDS can control, prevent, and treat serious complications.

When a patient with HIV takes effective treatment, the infection may never progress to stage 3. Treatment can also help a person recover some lost immune function, which will help ward off severe infections.


Opportunistic Infections and Cancer in HIV/AIDS

Stage 3 HIV reduces the body’s ability to combat a range of infections and associated complications and types of cancer.

Treatment is often effective enough to keep many infections at bay. If a patient with HIV does not receive treatment, latent infections that once caused minimal or no health problems can pose a serious risk. Doctors refer to these as opportunistic infections.

Below are some opportunistic infections that can signal to a doctor that a patient has stage 3 HIV:

  • Chronic Intestinal Isosporiasis: This occurs when the parasite Isospora belli enters the body through contaminated food and water, causing diarrhea, fever, vomiting, weight loss, headaches, and abdominal pain.
  • Candidiasis: A fungal infection that typically occurs in the skin and nails, but it often causes serious problems in the esophagus and lower respiratory tract in patients with AIDS.
  • Coccidioidomycosis: Inhalation of the fungus Coccidioides immitis causes coccidioidomycosis. A doctor may refer to this infection in healthy people as valley fever.
  • Cryptococcosis: This is an infection with Cryptococcus neoformans fungus. It may involve any part of the body, but the fungus usually enters the lungs and triggers pneumonia. It may also lead to swelling of the brain.
  • Cryptosporidiosis: Infection with the protozoan parasite Cryptosporidium can lead to severe abdominal cramps and chronic, watery diarrhea.
  • Cytomegalovirus disease (CMV): CMV can cause a range of diseases, including pneumonia, gastroenteritis, and encephalitis, a brain infection. CMV retinitis is a particular concern for people with AIDS. This is an infection of the retina at the back of the eye, and it permanently impairs a person’s sight. It is a medical emergency.
  • Herpes: This results from infection with the herpes simplex virus (HSV). This virus usually transmits when people have anal or vaginal sex without using barrier contraception, such as a condom. It can also transmit through vaginal childbirth. A doctor may recommend that a patient experiencing genital herpes close to delivery has cesarean delivery. This significantly lowers the risk of HSV transmitting to the baby.
  • Histoplasmosis: This fungal infection causes severe, pneumonia-like symptoms in people with advanced HIV. Histoplasmosis can also become progressive and widespread, affecting organs outside the respiratory system.
  • Tuberculosis (TB): The bacteria Mycobacterium causes TB. The bacteria can transfer through the air if a person with an active infection sneeze, coughs, or speaks. The signs and symptoms can include a severe lung infection, weight loss, a fever, and fatigue. It can spread to the brain and other organs.
  • Infections with Mycobacteria: Types of mycobacteria, including Mycobacterium avium and Mycobacterium kansasii, are naturally present and tend to cause few problems. However, when a person has HIV, especially in the later stages, these infections can spread throughout the body and cause life threatening health issues.
  • Recurrent Pneumonia: Many different pathogens can cause pneumonia, but Streptococcus pneumoniae bacteria can be one of the most dangerous for patients with HIV. A vaccine for this bacterium is available, and everyone with HIV should receive it.
  • Pneumocystis jirovecii pneumonia: An infection with this fungus can cause breathlessness, a dry cough, and a high fever in people with suppressed immune systems, including some patients with HIV.
  • Recurrent Salmonella septicemia: When Salmonella bacteria enter the body, usually via contaminated food or water, they can circulate and overpower the immune system, causing nausea, diarrhea, and vomiting. In this case, a doctor may diagnose recurrent Salmonella septicemia.
  • Toxoplasmosis: Toxoplasma gondii is a parasite that inhabits warm-blooded animals, including cats and rodents, and is present in their feces. Humans contract the resulting infection, called toxoplasmosis, by inhaling contaminated dust or eating contaminated food. It can cause severe symptoms involving the lungs, retina, heart, liver, pancreas, brain, testes, and colon. To reduce the risk of contracting toxoplasmosis, wear gloves while changing cat litter and thoroughly wash the hands afterward.


Diagnosis of HIV

According to ethe CDC about 13% of patients with HIV in the U.S. are unaware of their HIV status.

Being aware of their HIV status is crucial for a person’s health and well-being, as it can enable them to access the necessary treatment early and prevent complications.

Healthcare professionals can test a person’s blood for HIV antibodies. They will retest the blood before confirming a positive result. Also, there are home testing kits available for HIV test.

Current HIV testing platforms make it possible to detect HIV in under 2 weeks. People with known risk factors should undergo testing more frequently.

Anyone who thinks they may be at risk of contracting HIV can have a rapid test. If this is negative, the test provider usually recommends having another test within a few weeks.

The types of HIV tests are as follows:

  • Nucleic acid amplification tests, sometimes called NATs, can detect HIV as early as 10 days after exposure.
  • An antigen/antibody blood test can detect HIV in a blood sample as early as 18 days after exposure.
  • Most rapid tests and self-tests are antibody tests, and these can detect HIV antibodies as early as 21 days after exposure.

If a person thinks they have had exposure to HIV within the past 72 hours, they should talk with a healthcare professional about post-exposure prophylaxis (PEP)Trusted Source, a preventive treatment.

Additionally, there is a time between exposure to HIV and when a test can detect it known as the window period. However, the window period can vary between people and the type of test used to detect HIV.


Treatment of HIV

Currently, there’s no cure for HIV/AIDS. Once you have the infection, your body can’t get rid of it. However, there are many medications that can control HIV and prevent complications. These medications are called antiretroviral therapy (ART). Every patient diagnosed with HIV should be started on ART, regardless of their stage of infection or complications.

ART is usually a combination of two or more medications from several different drug classes. This approach has the best chance of lowering the amount of HIV in the blood. There are many ART options that combine multiple HIV medications into one pill, taken once daily.

Each class of drugs blocks the virus in different ways. Treatment involves combinations of drugs from different classes to:

  • Account for individual drug resistance (viral genotype)
  • Maximize suppression of virus in the blood
  • Avoid creating new drug-resistant strains of HIV

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